Alcohol Consumption Linked With Worsening Severity of Snoring, Sleep Apnea

Alcohol consumption was found to contribute to the lowest oxygen saturation (LSAT) observed among patients at risk of snoring and obstructive sleep apnea (OSA), with additional associations linked to worsening severity of snoring and impaired sleep architecture in select groups, according to study findings published in Otolaryngology—Head and Neck Surgery.

The health risk posed by severe OSA was noted by study authors as those with the condition have up to a 3-fold increased risk for all-cause mortality compared to those without. When monitoring patient risk for OSA, alcohol consumption has emerged as a notable risk factor that has been linked with the development or exacerbation of medical and mental health comorbidities. Moreover, prior studies have found that alcohol contributes to respiratory depression and the subsequent collapse of the oropharynx walls in OSA, causing severe worsening of the condition.

As these studies relied on self-reported data rather than the use of objective polysomnography (PSG) data parameters, researchers sought to review available PSG and respiratory data derived from recent studies analyzing the effect of alcohol consumption prior to sleep on the severity of OSA. Researchers performed a meta-analysis on 13 cohort studies (n = 279) that all included a follow-up, and of which 12 evaluated changes in the apnea-hypopnea Index (AHI) and 10 evaluated changes in oxygen saturation.

In the pooled analysis examining the difference in AHI and LSAT before and after alcohol consumption, significant mean differences were observed with AHI increasing by 3.98 events per hour (95% CI, 3.27-4.69; P < .001), and LSAT decreasing by 2.72% (95% CI, 23.69 to 21.76; P < .00001). For patients already distinguished as snorers, snoring was found to increase with alcohol consumption, but alcohol did not cause non-snorers to snore.

Postmenopausal women were indicated as an at risk group of impaired sleep architecture as alcohol consumption was found to significantly reduce REM sleep from 18.6% ± 6% to 11.1% ± 6.4% (P = .001). This trend was not observed in other studies of differing patient cohorts.

Researchers highlight that further studies examining the long-term effects of drinking are warranted. “Our review did highlight the paucity of large, well-designed, long-term trials and the need for these to determine the long-term effect of social drinking, heavy drinking, and chronic alcoholism on adults, especially those with OSA,” concluded the study authors.

Reference

Burgos-Sanchez C, Jones NN, Avillion M, et al. Impact of alcohol consumption on snoring and sleep apnea: A systematic review and meta-analysis [published online June 9, 2020]. Otolaryngol Head Neck Surg. doi: 10.1177/0194599820931087.